(The Center Square) – Even as the federal government sits at a standstill, states are eyeing up opportunities for funding made available in July’s Congressional Budget Resolution.
For Pennsylvania, investments in rural health are crucial to avoid deepening a crisis that is claiming the lives of one of the state’s most vulnerable populations. Policymakers in the state are looking at multi-pronged approaches as grant application deadlines loom in early November.
The Rural Health Transformation program established by Congress in July promises to allocate $50 billion to state governments to improve healthcare in less populated areas. The program calls for development in accessibility to care, workforce, innovative care models, and technology.
In Pennsylvania, each of these issues is a factor, and health care experts have frequently called for new financial models that will allow them to keep hospital doors open. It is in rural regions of the state where the aging population is most pronounced and where low- and fixed-income patients often require care that will ultimately go uncompensated. The result is hospital closures and ever-widening deserts of care.
Exacerbating the lack of access is a lack of available workforce to provide care in those places where it is available. Gov. Josh Shapiro’s most recent budget proposed incentives for bolstering the workforce through loan repayment programs for providers willing to live and work in rural areas. Parallelling the federal government, those opportunities remain in the ether until the impasse is resolved.
Unlike suburban, exurban, and urban communities, rural regions are less likely to have broadband coverage that allows for telehealth options to take over when distance and transportation to a doctor are prohibitive.
Mental health care, in particular, has been a major concern for state legislators who have observed high rates of suicide, drug abuse and other “diseases of despair” influenced largely by economic and cultural factors.
In a recent conversation with The Center Square, Don Hannaford, vice president for public policy at mental health organization Rural Minds said that while some issues – like stigma around mental health treatment – are improving, others – like employment opportunities and economic stability – are constant stressors.
“I would argue that the groundwork for mental illness is much higher in rural America,” said Hannaford.
A recent report from Pew Research Center analyzed opportunities within the Rural Health Transformation grants for states like Pennsylvania who are struggling with this problem. The group highlighted a 48% increase in suicide from the year 2000 to 2018 as well as high rates of overdose deaths.
Top on Pew’s list of suggested investments is improved screening for suicide at rural hospitals. By identifying patients who may be at risk and giving “warm hand-offs” from hospitals to social services and other community resources, the group is optimistic that hospitals could reverse trends.
The group’s remaining suggestions largely center around treatment for opioid use disorder. They recommend increasing access to Naloxone, a drug which reverses overdoses. They also recommend expanded treatment options in both telehealth and settings like federally qualified health care centers for medication assisted treatment.
